Problematic Internet Use Was Associated With Psychological Problems Among University Students During COVID-19 Outbreak in China

Background: As the coronavirus disease 2019 (COVID-19) pandemic progressed globally, school closures and home quarantine may cause an increase in problematic Internet use among students in universities. Such a traumatic stress event may also contribute to the development of posttraumatic stress disorder (PTSD), depressive, and anxiety symptoms. This study aimed to evaluate the prevalence of PTSD, depressive, and anxiety symptoms as well as the predictive role of problematic Internet use in the above-mentioned psychological problems in university students.

Methods: A cross-sectional study was conducted through an online survey of 8,879 students in China between April 20 and April 26, 2020. The presence of PTSD, depressive, and anxiety symptoms and problematic Internet use were evaluated using PTSD Checklist for DSM-5, the Center for Epidemiologic Studies Depression 9-item scale, the generalized anxiety disorder 7-item scale, and the Young diagnostic questionnaire, respectively. Sociodemographic information and the knowledge, attitude, and practice (KAP) toward COVID-19 data were also collected.

Results: A total of 4,834 (54.4%) participants were female, and 7,564 (85.2%) were undergraduate students. A total of 615 students (6.9%) reported PTSD symptoms; 5.2% (465) and 10.1% (896) reported moderate to severe depressive and anxiety symptoms, respectively. The problematic Internet use was significantly associated with higher risk of PTSD, depressive, and anxiety symptoms (odds ratio 2.662 [95% CI, 2.239–3.165], odds ratio 4.582 [95% CI, 3.753–5.611], odds ratio 3.251 [95% CI, 2.814–3.757], respectively; all P < 0.001). Lower attitude and practice scores also contributed to the risk of depressive, anxiety, and PTSD symptoms (P < 0.05).

Conclusions: Psychological problems should be paid more attention, and problematic Internet use may be a predictor when screening high-risk students for psychological problems. Our results will aid in timely psychological screening, which is meaningful in the prevention and intervention of psychological problems.

The Associations between Sleep Duration, Academic Pressure, and Depressive Symptoms among Chinese Adolescents: Results from China Family Panel Studies

Depressive symptoms are a common mental health problem among adolescents, which may affect their physical and mental health development and impose heavy burdens on individual families and society. This study aimed to examine the associations between sleep duration, academic pressure, and depressive symptoms among Chinese adolescents and to construct the mediation model to explore the mediating effect of sleep duration. The data are from the China Family Panel Studies (CFPS). Methodologically, the aforementioned associations were explored by constructing a structural equation model and applying multivariate multilevel logistic regression. In this study, we found that approximately 6.49% of the 3724 Chinese adolescents had depressive symptoms. Sleep duration of <6 h/night (OR = 2.39, 95%CI = 1.33-4.32) and high/maximum academic pressure (high: OR = 1.43, 95%CI = 1.02-1.99; maximum: OR = 2.43, 95%CI = 1.58-3.73) were both associated with an increased risk of depressive symptoms in adolescents. Meanwhile, the multiplicative interaction between sleep duration and academic pressure was significantly associated with depressive symptoms in adolescents (p < 0.001). The sleep duration played a partial mediating role in the relationship between academic pressure and depressive symptoms (a*b = 0.006, 95%BootCI = 0.001-0.012). Our study highlights that it is essential to mitigate the academic pressure of adolescents to increase their sleep duration and further reduce the occurrence of depressive symptoms by adopting corresponding preventive measures.

Association of Depressive Symptoms with Rapid Kidney Function Decline in Adults with Normal Kidney Function

BACKGROUND AND OBJECTIVES

The relationship of depressive symptoms with kidney function remains poorly investigated. We aimed to evaluate the prospective association between depressive symptoms and rapid decline in kidney function in Chinese adults with normal kidney function.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

A total of 4763 participants with eGFR≥60 ml/min per 1.73 m² at baseline were enrolled from the China Health and Retirement Longitudinal Study. Baseline depressive symptoms were determined using a ten-item Center for Epidemiologic Studies Depression scale with a cutoff score of greater than or equal to ten to define high depressive symptoms. The GFR was estimated by a combination of serum creatinine and cystatin C. The primary outcome was rapid decline in kidney function, defined as an annualized decline in eGFR of ≥5 ml/min per 1.73 m². Secondary outcome was defined as an annualized decline in eGFR of ≥5 ml/min per 1.73 m² and to a level of <60 ml/min per 1.73 m² at the exit visit.

RESULTS

During a median follow-up of 4 years (interquartile range, 3.92-4.00), 260 (6%) participants developed rapid decline in kidney function. Overall, there was a significant positive association between baseline depressive symptoms and rapid decline in kidney function (per five-scores increment; adjusted odds ratio, 1.15; 95% confidence interval, 1.03 to 1.28) after adjustments for major demographic, clinical, or psychosocial covariates. Consistently, compared with participants with low depressive symptoms (total Center for Epidemiologic Studies Depression scale score less than ten), a significantly higher risk of rapid decline in kidney function was found among those with high depressive symptoms (total Center for Epidemiologic Studies Depression scale score greater than or equal to ten; adjusted odds ratio, 1.39; 95% confidence interval, 1.03 to 1.88). Similar results were found for the secondary outcome (per five-scores increment; adjusted odds ratio, 1.26; 95% confidence interval, 1.06 to 1.51).

CONCLUSIONS

High depressive symptoms were significantly associated with a higher risk of rapid kidney function decline among Chinese adults with normal kidney function.

Exploring the Relationship between Depression on Menopausal Symptoms and Personality Trails

The aim of the present study was to explore the potential relationships between menopausal symptoms, sleep quality, hot flash, and depressive symptoms in postmenopausal women. A cross-sectional study was designed with 150 healthy postmenopausal women (45-60 years of age) who had referred to the menopausal clinic in Babol. The participants completed the following instruments throughout the study: the Beck Depression Inventory for depressive symptoms, the Modified Blatt-Kupperman Menopausal Index for measuring menopausal symptoms, and the NEO-FFI for identifying the personality traits. After controlling all the covariates, high depressive symptoms were found to be associated with moderate/sever menopausal symptoms, poor sleep quality, and the average and high level of neuroticism. The results also demonstrated that the risk of depressive symptoms was lower in menopausal women with high level extroversion, high level agreeableness, and the average and high level of conscientiousness. The findings of the present study indicated that personality traits, menopausal symptoms, and poor sleep quality in particular can partially account for depression in Iranian menopausal women. It is highly imperative that effective health education or implement appropriate strategies to improve the quality of life for these women.

Rural-Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

Altered Cerebral Blood Flow in Alzheimer's Disease With Depression

Background: Depression is common in Alzheimer's disease (AD) with an unclear neural mechanism. This study aimed to investigate the underlying cerebral perfusion associated with depression in AD and evaluate its clinical significance. Method: Twenty-one AD patients and 21 healthy controls (HCs) were enrolled in this study. The depressive symptom was defined according to the Hamilton Depression Rating Scale (HAMD). Nine patients were diagnosed as AD with depression symptoms (HAMD >7). Three-dimensional pseudocontinuous arterial spin labeling MR imaging was conducted to measure regional cerebral blood flow (CBF). Neuropsychological tests covered cognition and depressive scores. Between-group comparisons on clinical variables and regional CBFs, relationship between regional CBF and depressive score, and identification of AD patients with depression were performed using covariance analysis, linear regression, and receiver operating characteristic (ROC) analysis, respectively. Results: Compared with HCs, AD patients without depression exhibited lower gray matter CBF (p = 0.016); compared with AD patients without depression, AD patients with depression had higher CBF in the right supplementary motor area (39.23 vs. 47.91 ml/100 g/min, p = 0.017) and right supramarginal gyrus (35.54 vs. 43.85 ml/100 g/min, p = 0.034). CBF in the right supplementary motor area was correlated with depressive score (β = 0.46, p = 0.025). The combination of CBF in the right supplementary motor area and supramarginal gyrus and age could identify AD patients with depression from those without depression with a specificity of 100%, sensitivity of 66.67%, accuracy of 85.71%, and area under the curve of 0.87. Conclusions: Our findings suggested that hyperperfusion of the right supplementary motor area and right supramarginal gyrus were associated with depression syndrome in AD, which could provide a potential neuroimaging marker to evaluate the depression state in AD.

Depressive Symptom and Associated Factors Among School Adolescents of Urban, Semi-Urban and Rural Areas in Bangladesh: A Scenario Prior to COVID-19

Background: The purpose of this study was to investigate the prevalence of depressive symptom and the factors associated with this condition among urban, semi-urban and rural adolescents in the Dhaka district of Bangladesh. Methods: A cross sectional study using two stage cluster sampling procedure was performed. A self-administered questionnaire was conveyed to 2,355 adolescents from nine secondary schools of Dhaka district of Bangladesh. Of the respondents, 2,313 completed the nine item Patient Health Questionnaire (PHQ-9). Besides, sociodemographic information, self-reported body image as well as modification of Leisure Time Exercise Questionnaire (LTEQ) and WHO Global PA Questionnaire (GPAQ) were used to determine the sociodemographic and lifestyle factors associated with depressive symptom among adolescents. Results: A total of 30.1% adolescents were found to be suffering from moderate to severely severe depressive symptom. Females (60.8%) were found suffering significantly more than males (39.2%). Sociodemographic factors, for example, residential setting and family size were found significantly associated with depressive symptom among adolescents. Adjusted estimate of logistic regression shows that physical inactivity (AOR: 1.44; 95% CI: 1.14-1.84), >2 h/day screen time (AOR: 1.68; 95% CI: 1.39-2.03), sleep dissatisfaction (AOR: 3.23; 95% CI: 2.64-3.96), and underweight body image perception (AOR: 2.30; 95% CI: 1.70-3.13) were significantly associated with depressive symptom among adolescents. Conclusions: Among urban, semi-urban and rural school adolescents in Dhaka, Bangladesh, depressive symptom is quite prevalent. To lessen the spread of depressive symptom among Bangladeshi adolescents, urgent steps should therefore be taken.

Identifying the Factors That Affect Depressive Symptoms in Middle-Aged Menopausal Women: A Nationwide Study in Korea

Depressive symptoms do not persistently negatively affect functioning throughout the life span, but they may affect quality of life (QOL), especially in middle-aged women. Therefore, this study aimed to investigate the factors associated with depressive symptoms in premenopausal and postmenopausal women. This descriptive study was a secondary analysis of the data from the seventh Korea National Health and Nutrition Examination Survey that was conducted in 2016. Of the 8150 participants, the analysis included 644 premenopausal women and 459 postmenopausal women aged 40-60 years. The factors associated with depressive symptoms in the participants were examined using multivariate regression analysis. It was found that the depressive symptoms of postmenopausal middle-aged women were greater than those of premenopausal women. While a high perceived stress status and high pain-related discomfort were factors that influenced depressive symptoms among the premenopausal group, a high level of discomfort due to anxiety/depression, a poor perceived health status, shortened weekend sleep time, and smoking were associated with depressive symptoms in the postmenopausal group. Thus, it is necessary to develop an intervention to decrease depressive symptoms in postmenopausal women that considers their QOL, which is associated with depression, their subjective health status, sleep time, and smoking cessation.

Factors associated with symptoms of depression among pregnant women with gestational diabetes mellitus in Japan

The objective of this study was to explore the factors associated symptoms of depression among pregnant women with gestational diabetes mellitus (GDM) in Japan. This cross-sectional study was conducted at a hospital in Toyota, Japan, from January 2015 to June 2016. Pregnant women who visited the hospital and were diagnosed with GDM in the second trimester were enrolled. We analyzed depression symptoms using the Centers for Epidemiological Studies Depression Scale (CES-D) and considered related factors of depression symptoms, such as dietary intake and daily walking. Dietary intake during the past month was assessed using a brief self-administered diet history questionnaire, and daily walking was assessed using an accelerometer. The prevalence rate for GDM was 8.8%, and 25 pregnant women with GDM were analyzed. The CES-D was not significantly correlated with pre-pregnancy BMI, postprandial plasma glucose, hemoglobin A1c, and the number of steps walked. In contrast, a significant negative correlation was observed between the CES-D score and intake of fish with bones, simmered fish, pickles, green leaves, mushrooms, and green tea. Furthermore, a significant positive correlation was found between Coke^® and CES-D scores. For nutrient intake, a significant negative correlation was found between the CES-D score and vitamin K, folate, and β-carotene levels. The present study suggests that depression symptoms among pregnant women with GDM in the second trimester may be associated with diet.

Effect of Bright Light Therapy on Depressive Symptoms in Middle-Aged and Older Patients Receiving Long-Term Hemodialysis

Depressive symptoms are common psychiatric comorbidities among individuals receiving long-term hemodialysis. The aim of this two-arm parallel design study is to assess the effects of bright light therapy (BLT) on depressive symptoms among middle-aged and older adults receiving long-term hemodialysis. Study participants are recruited using convenient sampling from four dialysis clinics in eastern Taiwan. The eligible participants are block-randomized to either the BLT group (n = 30), with 30 min sessions of BLT five times a week for six weeks at their own home, or to the routine care control group (n = 30). The Beck Depression Inventory-II (BDI-II) scores and the salivary cortisol levels are obtained from the participants at three time points: baseline (T₀), week 3 (T₁), and week 6 (T₂). The results, from the generalized estimating equations, indicate that the decline in the BDI-II scores over time is significant in the BLT group at T₁ (β = -7.57, p < 0.001) and at T₂ (β = -6.20, p = 0.002) compared to the control group. The decrease in salivary cortisol levels at each visit is also significant in the BLT group at T₁ (β = -7.37, p = 0.017) and at T₂ (β = -12.22, p = 0.005) compared to the control group. Our findings support the hypothesis that a six-week program of BLT is able to alleviate depressive symptoms in middle-aged and older patients who receive long-term hemodialysis.

Resilience Moderated the Predictive Effect of Dual Stigma on Distress Among Chinese Newly Diagnosed HIV-Positive Men Who Have Sex With Men

Previous studies have examined the distinct stigmas of people living with HIV or of men who have sex with men (MSM). To capture the composite stress of HIV-positive MSM and the mixed stigma they experience, we conceptualized a compound stigma combining HIV status and homosexual identity. At two waves with an interval of 6 months, the results of 112 Chinese newly diagnosed HIV-positive MSM showed that dual stigma at baseline increased distress symptoms 6 months later. Resilience moderated these effects, as the dual stigma increased, distress symptoms intensified more rapidly for individuals with lower resilience than they did for those with higher resilience. Our findings highlight that dual stigma, as an intensified risk factor, predicted distress among the Chinese newly diagnosed HIV-positive MSM, conditioned by the protective factor of resilience. The results have strong implications for developing resilience-based intervention programs in this population.

Parenting Style and Emotional Distress Among Chinese College Students: A Potential Mediating Role of the Zhongyong Thinking Style

Previous studies suggested that parenting style was associated with college student’s emotional distress. However, little is known about the underlying mechanisms of this relation in Chinese culture. The present study investigated the associations between parenting style and college student’s emotional distress (depression and anxiety symptoms), examined the mediating effects of Confucian personality-Zhongyong thinking, and explored whether gender, age, and socioeconomic status (SES) moderated the direct and/or indirect effects of parenting style on emotional distress. Results from a large representative sample of Chinese college students (n = 3943) indicated that (a) parental rejection and overprotection was positively and mildly associated with depressive and anxiety symptoms and negatively and mildly related to Zhongyong thinking. Parental warmth significantly correlated with the three variables in the opposite direction; Zhongyong thinking correlated negatively and moderately with depression, and mildly with anxiety; (b) Zhongyong thinking partially mediated the associations of parental rejection and warmth with emotional distress. Specifically, to the extent that students perceived less rejection and more warmth, they were more likely to develop Zhongyong thinking associated with decreased emotional distress; (c) gender and SES moderated the association between parenting style and Zhongyong thinking. Specifically, for students with low SES, the negative relationship between parental overprotection and Zhongyong thinking was stronger; for males and high SES students, the positive link between parental warmth and Zhongyong thinking were stronger. Results highlight the importance of researching potential effects of college student’s Zhongyong thinking within the family system in Chinese culture.

Sex Differences in Factors Affecting Depressive Symptoms in Older People in the Prefrailty Phase

Depressive symptoms experienced late in life have considerable effects on the prevalence of comorbidity with physical and cognitive disabilities. By identifying and intervening on modifiable indicators for depression in prefrail older individuals, progression to the frailty phase can be delayed, and physical, psychosocial, and cognitive health problems of older people can be reduced and prevented. This study assessed sex differences in factors affecting depressive symptoms in older people in the prefrailty phase in Korea. Data from the 2014 National Survey of Older Koreans revealed 1706 women and 662 men in the early stages of old age. Regression analysis showed that economic status, number of medications, social support, nutritional status, and fear of falling collectively accounted for 39.0% of the variance among older men. Using the same analysis method, economic status, number of chronic diseases, number of medications, chewing discomfort, regular exercise, social support, mobility, nutritional status, and fear of falling collectively accounted for 37.5% of the variance among older women. Based on differences in characteristics with respect to the sex of older people in the prefrailty phase, public health workers in the community should consider sex differences when planning a frailty management program.

Only Children Were Associated with Anxiety and Depressive Symptoms among College Students in China

This study explored the prevalence of anxiety and depressive symptoms among college students and analyzed the associations between only children and anxiety and depressive symptoms in college students in China. A total of 645 college students, from three universities in Jinan, Shandong, China, were investigated by questionnaire. The self-designed general information questionnaire was used to collect the demographic information such as gender, age, only children or not and so on. The Self-rating Anxiety Scale and Self-rating Depression Scale were used to reflect the psychological state of college students. Binary logistic regression analysis was applied to analyze associated factors of anxiety and depressive symptoms. We have found that there were 25.7% college students with anxiety symptom, 22.2% college students with depressive symptom, and 18.3% college students with a comorbidity of anxiety and depressive symptoms. The prevalence of anxiety symptom, depressive symptom, and comorbidity of anxiety and depressive symptoms in only children was higher than those among non-only children. There were no differences between males and females in anxiety symptom, depressive symptom, and comorbidity of anxiety and depressive symptoms among all college students, only child college students and non-only child college students. Only children were associated with anxiety symptom, depressive symptom, comorbidity of anxiety and depressive symptoms after adjusting potential important confounding factors, such as professional category, grade, parental relationship, parenting style, interpersonal relationship, activity participation enthusiasm, sleeping time, and eating habits. The prevalence of anxiety and depressive symptoms among college students was high. We should pay more attention to the mental health of college students, especially that of only child college students.

Predictors of life skills in people with schizophrenia

Objective : The purpose of the present study is to examine clinical factors related to life skills in people with schizophrenia. Method : The participants were 51 stabilized outpatients with schizophrenia. Their mean age was 38.91 (SD = 10.73) years. Life skills were assessed using the Life skills profile (LSP). Cognitive function was evaluated with the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB). Clinical symptoms were assessed using the Positive and Negative Syndrome scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). Results : Cognitive function was not correlated with the LSP scores at all. Among clinical symptoms, scores of the PANSS positive and negative syndrome scales, the CDSS, and the DIEPSS had negative correlations with the LSP total score and the subscales. Stepwise regression analyses showed that the CDSS and PANSS negative syndrome scale scores were independent predictors of the LSP total score and two of the subscales. Conclusions : These results indicate that cognitive function is not associated with life skills but clinical symptoms such as depressive and negative symptoms have considerable impacts on life skills in people with schizophrenia. J. Med. Invest. 67 : 75-82, February, 2020.

[Influencing factors of depressive symptoms of rural middle school students in Zizhong County based on two-level Logistic regression model]

OBJECTIVE

To understand the prevalence of depressive symptoms of middle school students in rural areas of Zizhong County, and to analyze its main influencing factors.

METHODS

In October 2015, two rural middle schools in Zizhong County, Sichuan Province, were selected to conduct a self-administered questionnaire survey(general demographic characteristics, the center for epidemiological studies depression scale(CES-D), self-esteem scale(SES) and connor-davidson resilience scale(CD-RICS)) on all the students(there were 2744 effective persons, including 1308 boys and 1436 girls, 554 middle school students and 2190 high school students), and then carried out a follow-up survey every semester.

RESULTS

The prevalence of depressive symptoms was 30. 5%(in the baseline survey, it was 26. 7%, the third 35. 7% and the fifth 29. 8%), and the rate of female students was 30. 3%, higher than that of male students 22. 9%(χ~2=19. 72, P&lt;0. 05). The main influencing factors of depressive symptoms of rural middle school students in Sichuan were gender(β=0. 201, P=0. 001), be aware of whether teacher liked or not(β=0. 228, P=0. 005), be aware of whether classmates liked or not(β=0. 488, P&lt;0. 001), be aware of the relationship with parents(β=0. 201, P=0. 001), the power of the psychological resilience(β=0. 046, P&lt;0. 001) and the optimism of the psychological resilience(β=-0. 030, P=0. 038), self-esteem(β=-0. 140, P&lt;0. 001).

CONCLUSION

The depression symptoms of adolescents are related to many factors. The self-conscious teachers and classmates do not like himself(herself), and the bad relationship with parents are positively related to the depression symptoms of adolescents, while the psychological resilience and self-esteem are negatively related. The multi-level Model of repeated measurement is suitable for the analysis of the influencing factors and their changing rules in the longitudinal study of depression symptoms.

Homozygosity in the APOE 3 Polymorphism Is Associated With Less Depression and Higher Serum Low-Density Lipoprotein in Chinese Elderly Schizophrenics

Background: Depressive symptoms are common comorbidities in schizophrenia. However, the effect of APOE E3 on depressive symptoms has never been investigated in an aging Chinese population with schizophrenia. This cross-sectional study aimed to investigate the effects of APOE E3 on blood lipid metabolism and depressive symptoms in elderly schizophrenics in China. Methods: Three Hundred and one elderly schizophrenics (161 males, age ranges from 60 to 92 years, with an average age of 67.31 ± 6.667) were included in the study. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). APOE gene polymorphism was determined by polymerase chain reaction (PCR). We assessed the correlations of GDS and serum low-density lipoprotein (LDL) with APOE genotypes. Results: The concentration of LDL in the Homozygous APOE E3 group was significantly higher than that in the non-homozygous APOE E3 group, while the scores of GDS of the Homozygous APOE E3 group were lower than that in the non-homozygous APOE E3 group. Using partial correlation analysis and controlling age, gender, duration of disease, and hyperlipidemia, we found that the scores of GDS were significantly correlated with LDL (r = -0.194, p = 0.016). Conclusions: APOE E3 is associated with less depressive symptoms and higher serum LDL in Chinese elderly patients with schizophrenia, and there is a negative correlation between depressive symptoms and LDL.

Mild to Severe Depressive Symptoms in Elderly Stroke Survivors and Its Associated Factors: Evidence From a Cross-Sectional Study in Zhejiang Province, China

Objective: The objective of the study is to explore the prevalence of mild to severe depressive symptoms in elderly stroke survivors and its associated factors. Methods: We did data analyses of 335 elders with stroke history. Data were collected in a survey conducted between 2014 and 2015, among permanent residents aged 60 and older in Zhejiang Province, China. Prevalence of mild to severe depressive symptoms among stroke survivors were calculated, and univariate analyses and multilevel logistic regression were used to explore its associated factors. Results: Prevalence of mild to severe depressive symptoms was 22.09% (95% CI: 17.65-26.53%) in elders with stroke history, more than twice compared to their counterparts not suffering stroke (9.77%, P < 0.001). In multilevel logistic regression, we found that elderly stroke survivors who were illiterate (OR = 2.33, p = 0.008), or had limitation in activities of daily living (OR = 3.04, p = 0.001) were more likely to be present with mild to severe depressive symptoms, respectively, while those with more fresh vegetable consumption were at lower odds (OR = 0.82, p = 0.047). Conclusions: Prevalence of mild to severe depressive symptoms was high in elderly stroke survivors. Targeted screening might be needed for those being illiterate, disabled in activities of daily living, and having little consumption of fresh vegetable. The association between fresh vegetable consumption and depressive symptom in stroke patients calls for further research.

Association Between Multimorbidity and Depressive Symptom Among Community-Dwelling Elders in Eastern China

Purpose

This study aimed to investigate the prevalence of depressive symptoms and the association between multimorbidity and depressive symptoms among the elderly in eastern China.

Patients and methods

A multicenter cross-sectional study was conducted in four cities (Jianggan, Yiwu and Anji in Zhejiang Province and Taixing in Jiangsu Province) in eastern China. We collected the information on 27 chronic conditions through the self-reported medical history and used the Geriatric Depression Scale (GDS) short form to evaluate depressive symptoms. Multivariate Logistic regression was used to evaluate the relationship between multimorbidity and depressive symptoms.

Results

Five thousand two hundred and ninety-six participants were included into the current study, among which 2687 (50.74%) were female, with the mean ± SD age 72.0 ± 8.1 years old. The overall prevalence of depressive symptoms in eastern China was 23.5%. And the percentage of multimorbidity in depressed participants was higher compared with non-depressed participants (50.8% vs 38.8%, P<0.001). The univariate model and adjusted model suggested that participants with multiple chronic diseases were more likely to have a depressive symptom (adjusted OR=1.42; 95% CIs 1.19–1.70).

Conclusion

Depressive symptom was significantly associated with multimorbidity among the community-dwelling elderly population in eastern China.

The Co-Occurrence Of Frailty (Accumulation Of Functional Deficits) And Depressive Symptoms, And Its Effect On Mortality In Older Adults: A Longitudinal Study

Purpose

The co-occurrence of frailty and depression in late life, the possibility for symptom reversal, their reciprocal relationship, and the effects on mortality have rarely been investigated. We aimed to examine the co-occurrence of frailty and depressive symptoms in late life, the possibility for symptom reversal, their reciprocal relationship, and the effects on mortality using all the information from a longitudinal study.

Patients and methods

We used the Taiwan Longitudinal Study of Aging (TLSA) for this study. TLSA was initiated in 1989 and followed periodically. We included participants from 1989 to 2007, who had data on frailty and depressive symptoms. Frailty was assessed by accumulation of functional deficits in 6 dimensions including disease status, sensory dysfunction, balance, functional limitations, health risk behaviors, and life satisfaction. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). A multistate model with interval censoring was used to examine the transition between states of frailty with or without depressive symptoms, and finally to death. A mixed model was used to examine the relationships between frailty and depressive symptoms.

Results

The coexistence of frailty and depressive symptoms was associated with higher mortality. Individuals with depressive symptom had a lower probability of reversal to a better state. Previous depression score predicted current frailty, but the coefficient was smaller than that of previous frailty. Previous frailty predicted current depression score, and the coefficient was stronger than that of previous depression.

Conclusion

Depressive symptoms increased the mortality and decreased the probability of reversal in the frail older adults.

Protective and risk factors for depressive mood and anxiety against occupational stress: examining temperament character and coping strategy among civil servants

This study investigated protective and risk factors for depressive mood and anxiety against occupational stress, including temperament character and coping strategy, among civil servants. We administered a questionnaire that included demographic factors and psychological scales to 1197 Korean civil servants. High levels of occupational stress, temperaments of novelty seeking and harm avoidance, a character of cooperativeness, and using emotion-focused coping were risk factors for depressive mood, while living with a partner, having a character of self-directedness, and using problem-focused strategies were protective factors. Additionally, female gender, high level of occupational stress, and temperaments of novelty seeking and harm avoidance were risk factors for anxiety, while having a character of self-directedness was a protective factor. Assessment of temperament character and training on effective coping strategies may help address depressive mood and anxiety for civil servants.

Influence of smoking habits on mental status in Japanese women during the first trimester of pregnancy

PURPOSE

We examined the relation between smoking habits and maternal mental status such as depression and anxiety during the first trimester of pregnancy.

MATERIAL AND METHODS

Between July 2016 and June 2018, we examined the increased odds of depressive and anxiety symptoms in the women with smoking habits during prepregnancy with and without smoking cessation during the first trimester of pregnancy in comparison with those without smoking habits using self-administered questionnaires.

RESULTS

The rate of depressive and anxiety symptom in the women with smoking habits during prepregnancy (46.4 and 47.3%, respectively) was higher than those in the women without smoking habits during the first trimester of pregnancy irrespective of smoking cessation. The rate of depressive or anxiety symptom during the first trimester of pregnancy did not change significantly by smoking cessation in the women with smoking habits during prepregnancy (depressive symptom: 44.6 versus 53.7%, p = .13; anxiety symptom: 45.3 versus 55.2%, p = .17).

CONCLUSIONS

Smoking habits during prepregnancy seemed to be associated with the increased perinatal mental disorders irrespective of smoking cessation.

Role of socioeconomic status and housing conditions in geriatric depression in rural China: a cross-sectional study

OBJECTIVES

The primary aim of this study was to describe the socioeconomic status (SES), housing conditions and depression of the elderly in rural China, as well as to examine the associations between depression and SES and housing conditions using the China Health and Retirement Longitudinal Study (CHARLS).

DESIGN

This is a cross-sectional study.

SETTING

A nationally representative sample of elderly in rural China.

PARTICIPANTS

A total of 4585 elderly adults in 2015 in rural China.

OUTCOME MEASURES

Prevalence and risk factors of depression among rural elderly.

RESULTS

Among the participants in this study, approximately 46.15% (2116/4585) reported depressive symptoms (10-item Center for Epidemiologic Studies Depression Scale [CESD-10] score >10) in rural China. The results revealed significant associations between higher scores on CESD-10 (indicating more symptoms of depression) and lowest personal annual income (OR=1.63, 95% CI 1.290 to 2.060), polluting cooking fuel (OR=1.16, 95% CI 1.018 to 1.321), toilet without seat (OR=1.273, 95% CI 1.056 to 1.535), as well as having no bath facility (OR=1.172, 95% CI 1.025 to 1.341) after adjustment for confounders.

CONCLUSION

Elderly in rural China experienced severe depressive symptoms. Lowest personal annual income, polluting cooking fuel, toilet without seat and having no bath facility were significantly associated with more depressive symptoms. Caution needs to be taken in generalising the findings of this study to the rest of the population in China since its highly selected sample.

Positive and negative social support and depressive symptoms according to economic status among adults in Korea: cross-sectional results from the Health Examinees-Gem Study

OBJECTIVES

The interaction between positive and negative social support as well as each domain of social support and income on depressive symptom has not been much explored. We aimed to examine the associations of positive and negative social support with the risk of depressive symptoms among urban-dwelling adults in Korea, focusing on those interaction effects.

DESIGN

We used the first wave of a large-scale cohort study called The Health Examinees-Gem Study. Positive and negative support scores ranged between 0 and 6; the variables were then categorised into low, medium, and high groups. A two-level random intercept linear regression model was used, where the first level is individual and the second is the community. We further tested for interactions between each domain of social supports and household income.

SETTING

A survey conducted at 38 health examination centres and training hospitals in major Korean cities and metropolitan areas during 2009-2010.

PARTICIPANTS

21 208 adult men and women aged between 40 and 69 in Korea (mean age: 52.6, SD: 8.0).

OUTCOME MEASURES

Depressive symptoms score measured by Epidemiologic Studies-Depression Scale, with scores ranging from 0 to 60.

RESULTS

Level of positive and negative social support showed a negative and positive association with depressive symptom score with statistical significance at p<0.05, respectively. When the interaction terms among household income and social supports were examined, a negative association between level of positive social support and depressive symptom score was more pronounced as income was lower and level of negative social support was higher. Similarly, positive association between level of negative social support and depressive symptom score was more pronounced as income was lower and level of positive social support was lower.

CONCLUSIONS

Our findings suggest that strategies for encouraging positive social support and discouraging negative social support for disadvantaged individuals might be effective in reducing depression in Korea.

Depressive symptoms in adolescents in Kuching, Malaysia: Prevalence and associated factors

BACKGROUND

The trend of depression is rising worldwide. There are limited studies on depression in adolescents. The aim of this study was to estimate the prevalence of and identify the factors associated with depressive symptoms in adolescents in Kuching, Malaysia, and to analyze the relationship between depressive symptoms and suicidal ideation.

METHODS

A cross-sectional study was conducted in 320 students from urban and rural secondary schools. The participants were randomly selected via multi-stage sampling. They completed the Malay versions of the Children's Depression Inventory (CDI) and Beck Scale for Suicide Ideation (BSS).

RESULTS

The prevalence of depressive symptoms was 26.2%. On binary logistic regression analysis, variables with significant association with depressive symptoms were race (P = 0.028), type of class (P < 0.001), mother's education level (P = 0.036), type of housing (P = 0.036), parents' marital status (P = 0.012), alcohol intake (P = 0.005), stealing (P < 0.001) and history of disciplinary record (P = 0.005). Variables that remained significant on multivariable logistic regression were type of class (P = 0.004), parents' marital status (P = 0.017) and stealing (P < 0.001). Students from the Arts stream (OR, 2.43) with parents who were separated, divorced or widowed (OR, 3.13) and who had experience of stealing (OR, 3.27) were predicted to be at risk of developing depressive symptoms. There was a significant correlation between total CDI score and total BSS score (P < 0.001).

CONCLUSIONS

The prevalence of depressive symptoms in adolescents was high. Depressive symptoms are significantly correlated with suicidal ideation. Greater collaboration between the education and health agencies is essential for mental health promotion in schools and early detection of depression, especially in at-risk adolescents.

Moderating Effect of Mindfulness on the Relationships Between Perceived Stress and Mental Health Outcomes Among Chinese Intensive Care Nurses

This study aimed to explore the potential moderating effect of mindfulness and its facets on the relationships among perceived stress and mental health outcomes (burnout, depression, anxiety, and subjective well-being) among Chinese intensive care nurses. A total of 500 Chinese intensive care nurses completed self-report measures of mindfulness, burnout syndromes, perceived stress, depression, anxiety, and subjective well-being. Correlation and hierarchical multiple regressions were applied for data analysis. Mindfulness moderated the effects of perceived stress on emotional exhaustion (the core component of burnout syndrome), depression, anxiety, positive affect, and negative affect but not on the other two dimensions of burnout and life satisfaction. Further analyses indicated that the ability to act with awareness was particularly crucial in improving the effects of perceived stress on depression. These results further broaden our understanding of the relationships between perceived stress and burnout, depression, anxiety, and subjective well-being by demonstrating that mindfulness may serve as a protective factor that alleviates or eliminates the negative effects of perceived stress on depression, anxiety, burnout syndrome, and subjective well-being and may instigate further research into targeted mindfulness interventions for Chinese intensive care nurses.

Depression, Anxiety and Their Correlates Among Patients With HIV in South Ethiopia: An Institution-Based Cross-Sectional Study

Background: Depressive and anxious symptoms are more regularly seen in HIV-infected people than in the general population. This investigation planned to evaluate the magnitude and factors related to depressive and anxiety symptoms among HIV patients in South Ethiopia, 2018. Methods: This was an institution-based cross-sectional study directed among 363 HIV-infected individuals who had a customary visit at Hawassa University Comprehensive Specialized Hospital and Yirgalem Hospital, Ethiopia, who were incorporated into the study through systematic sampling techniques. The hospital anxiety and depression scale (HADS) was utilized to take a look at anxious and depressive symptoms. Results: The mean age of the respondents was 37.66 years (SD ±10.03). The prevalence of depression and anxiety were 32.0% and 34.4%, respectively. Patients who were living alone [AOR = 1.94, (95% CI: 1.06, 3.56)], had poor social support [AOR = 5.57, (95% CI: 1.20, 10.84)] or had HIV-related perceived stigma [AOR = 2.35, (95% CI: 1.44, 3.84)] were more likely to have depression as compared to their counterparts. Those with a previous history of mental illness [AOR = 3.36, (95% CI: 1.31, 8.61)] and poor social support [AOR = 6.67, (95% CI: 1.47, 10.33)] were more likely to have anxiety symptoms. Conclusion: The prevalence of anxiety and depression in the current study was high. Concerned health departments of the country should create guidelines to screen and treat depression and anxiety among HIV patients. Further research on hazard factors of depression and anxiety ought to be examined to strengthen and expand these findings.

Association between plasma α-aminobutyric acid and depressive symptoms in older community-dwelling adults in Japan

AIM

To examine the association between depressive symptoms and plasma amino acid related metaboli in older adults.

METHODS

A total of 152 older adults aged ≥65 years, residing in Niigata, Japan, were used for analysis. We evaluated depressive symptoms using the Geriatric Depression Scale-15, which has been validated in older community-dwelling individuals, and used a cut off score of ≥5 to classify participants as having depressive symptoms. We used high-performance liquid chromatography-electrospray ionization mass spectrometry to measure the concentrations of plasma amino acid-related metabolites, and carried out logistic regression analysis to assess the association between depressive symptoms and plasma amino acid-related metabolites.

RESULTS

Of the 119 older adults (mean age 76.3 years) included in the analysis, 22 were classified as having depressive symptoms (depressive group). There were no significant differences in physical and cognitive impairments between participants in the depressive and non-depressive groups. The plasma α-aminobutyric acid (AABA) level was significantly lower in the depressive group than in the non-depressive group (P < 0.001). Logistic regression analysis showed the best-fit model, which included AABA, leucine, threonine, hydroxyl proline and histidine levels (area under the receiver operating characteristic curve 0.8346; 95% confidence interval 0.7365-0.9326). In particular, the plasma AABA level was strongly associated with depressive symptoms.

CONCLUSIONS

Plasma AABA level is significantly associated with depression symptoms in older community-dwelling adults in Japan. Thus, plasma AABA might serve as a potential marker of depression in older adults aged ≥65 years. Geriatr Gerontol Int 2019; 19: 254-258.

Characteristics of apathy in treatment-naïve patients with Parkinson's disease

INTRODUCTION

Although apathy is a common psychiatric symptom of Parkinson's disease (PD), there are many unknown aspects of its pathology. This study aimed to investigate the characteristics of apathy in treatment-naïve patients with early-stage PD.

METHODS

Fifty treatment-naïve patients with early-stage PD were divided into 1 of 2 groups-apathetic or non-apathetic-based on Starkstein Apathy Scale (AS) scores. Cognitive function, depressive symptoms, olfactory function, and motor severity were compared between the two groups using validated assessment scales. Multiple linear regression was performed to assess the association between AS scores and clinical parameters.

RESULTS

Apathy (AS score ≥16) was observed in 13 (26%) patients. Assessment scale scores (Beck Depression Inventory-Second Edition [p < .004]; modified Hoehn & Yahr stage [p = .039]; Unified Parkinson's Disease Rating Scale part III [p < .001]) were significantly higher in apathetic patients than in non-apathetic patients. Significant association between these scale scores and AS score was also evident (all p ≤ .001). There were no significant differences in the test scores derived from several other validated scales.

CONCLUSION

Apathy was observed in 26% of treatment-naïve patients with early-stage PD. Significant association between apathy and motor severity was found, suggesting that dysfunction of the dopaminergic pathway is involved in the pathology of apathy.

Chronic Intra Oral Pain and Depressive Symptoms in Japanese Community-Dwelling Elderly: A Longitudinal Study

OBJECTIVE

The incidence of major depressive disorder in the elderly ranges from 0.2 to 14.1/100 person-years, and the incidence of clinically relevant depressive symptoms is 6.8/100 person-years. This study aimed to assess the longitudinal relationship between chronic intra oral pain and depressive symptom in Japanese elderly.

BASIC RESEARCH DESIGN

3-year cohort study.

PARTICIPANTS

212 community-dwelling seniors (129 men, 83 women) aged 77 years residing in the city of Niigata, Japan in 2005.

INTERVENTIONS

At baseline, subjects were asked about chronic intra oral pain (tooth, gingival or denture pain), with response choices of "yes" or "no". Any type of pain, was counted as chronic intra oral pain.

MAIN OUTCOME MEASURES

The General Health Questionnaire 30 (GHQ-30) was used to assess depression at follow up. The Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence was used to assess activities of daily living.

RESULTS

In multivariate logistic regression, baseline intra oral pain predicted depressive symptoms at follow up (Odds Ratio = 3.2, 95% CI = 1.32-7.81) after adjusting for serum HbA1c, creatinine and working life.

CONCLUSIONS

Chronic intra oral pain increased the risk for the development of depressive symptoms in the elderly.

Role of resilience and social support in alleviating depression in patients receiving maintenance hemodialysis

BACKGROUND

Patients who undergo hemodialysis encounter challenges including role changes, physical degeneration, and difficulty in performing activities of daily living (ADLs) and self-care. These challenges deteriorate their physiological and psychosocial conditions, resulting in depression. High resilience (RES) and social support can alleviate stress and depression. This study evaluated the importance of RES and social support in managing depression in elderly patients undergoing maintenance hemodialysis (HD).

PATIENTS AND METHODS

In this descriptive, correlational study, 194 older patients undergoing HD were enrolled from the HD centers of three hospitals in northern Taiwan. The Barthel ADL Index, RES scale, Inventory of Socially Supportive Behavior, and Beck Depression Inventory-II were used. Hierarchical regression analysis was applied to evaluate the interaction of RES and social support with illness severity, demographics, and ADLs.

RESULTS

Of the total participants, 45.9% experienced depressive symptoms. Demographic analysis showed that men and those with high educational level and income and financial independence had less depression (p<0.01). Patients with a higher Barthel Index (n=103), RES scale (n=33), and social support (n=113) showed less depressive symptoms (p<0.01). We found a significant negative correlation between depressive symptoms and social support (r=-0.506, p<0.01) and RES (r=-0.743, p<0.01). Hierarchical regression analysis showed that RES could buffer the effects of symptom severity on depression (b=-0.436, p<0.01), but social support did not exert a buffering effect.

CONCLUSION

The severity of illness symptoms and ADLs were the major determinants of depressive symptoms. High RES could alleviate depressive symptoms in the older patients undergoing HD.

Impact of depression on change in coronary heart disease risk status: the Korean Genome and Epidemiology Study (KoGES)

Purpose

The objective of this study was to evaluate the association between depression and change in coronary heart disease (CHD) risk status by an analysis of examination data in the general Korean population.

Patients and methods

We examined 1,851 men and 1,689 women (aged 43–73 years) for the Korean Genome and Epidemiology Study Ansan between 2005 and 2012. The estimated CHD risk score of participants was calculated using the Framingham CHD risk score in baseline and after 8-year follow-up period. Among them, population with low Framingham CHD risk score (<10%) in baseline (n=1,582) was used for further analyses. The low Framingham CHD risk score participants were assigned to one of two groups based on the Beck depression inventory (BDI) score: no depression (BDI <10) and depression (BDI ≥10). Multivariate logistic regression was performed to test whether depression was associated with participants’ status change to intermediate or high CHD risk score (≥10%) in men and women, respectively, after 8-year follow-up period.

Results

Women with depression showed significant higher rates of changing to intermediate or high CHD risk score status when compared with women without depression even after adjusting for age, systolic blood pressure, high-density lipoprotein, and smoking (adjusted odds ratio [OR], 1.54; 95% CI, 1.08–2.03). However, depression was not associated with intermediate or high CHD risk score status in men (adjusted OR, 1.38; 95% CI, 0.95–1.82).

Conclusion

This general population-based cohort study provides evidence that depression can affect the risk of changing CHD risk score status in women.

From job stress to intention to leave among hospital nurses: A structural equation modelling approach

AIMS

The aim of this study was to examine the structural relationships linking job stress to leaving intentions through job satisfaction, depressed mood and stress adaptation among hospital nurses.

BACKGROUND

High turnover among nurses is a global concern. Structural relationships linking job stress to leaving intentions have not been thoroughly examined.

DESIGN

Two nationwide cross-sectional surveys of full-time hospital staff in 2011 and 2014.

METHODS

The study participants were 26,945 and 19,386 full-time clinical nurses in 2011 and 2014 respectively. Structural equation modelling was used to examine the interrelationships among the study variables based on the hypothesized model. We used cross-validation procedures to ensure the stability and validity of the model in the two samples.

RESULTS

There were five main paths from job stress to intention to leave the hospital. In addition to the direct path, job stress directly affected job satisfaction and depressed mood, which in turn affected intention to leave the hospital. Stress adaptation mitigated the effects of job stress on job satisfaction and depressed mood, which led to intention to leave the hospital. Intention to leave the hospital preceded intention to leave the profession. Those variables explained about 55% of the variance in intention to leave the profession in both years.

CONCLUSION

The model fit was good for both samples, suggesting validity of the model. Strategies to decrease turnover intentions among nurses could focus on creating a less stressful work environment, increasing job satisfaction and stress adaptation and decreasing depressed mood. Hospitals should cooperate in this issue to decrease nurse turnover.

Is serum 25-hydroxyvitamin D associated with depressive symptoms and suicidal ideation in Korean adults?

OBJECTIVE

Mixed results exist regarding the role of vitamin D deficiency in depression and suicidal ideation. The present study investigated the relationships among vitamin D, depressive symptoms, and suicidal ideation in a large representative of the general population of Korea.

METHOD

The data from the fifth Korea National Health and Nutrition Examination Surveys conducted by the Division of Chronic Disease Surveillance, Korea Centers for Disease Control and Prevention, from 2010 to 2012 were investigated. A total of 15,695 subjects aged 20 and older were included in analysis. Depressive symptoms and suicidal ideation were evaluated based on self-report information. The serum 25-hydroxyvitamin D concentrations were measured by radioimmunoassay. The associations among vitamin D, depressive symptoms, and suicidal ideation were explored using multivariate logistic regression analysis adjusting for various confounding variables including sociodemographic and health-related variables.

RESULTS

Serum 25-hydroxyvitamin D concentrations were not significantly different depending on the depressive symptoms (participant with depressive symptom, n = 2085, 17.10 ng/ml; without depressive symptom, n = 13,610, 17.36 ng/ml; p = 0.142) and suicidal ideation (participant with suicidal ideation, n = 2319, 17.31 ng/ml; without suicidal ideation, n = 13,374, 17.33 ng/ml; p = 0.926). After adjustment for sociodemographic and health-related factors, this lack of relationship was held consistent in the multivariate logistic regression.

CONCLUSIONS

Significant associations were not observed among vitamin D, depressive symptoms, and suicidal ideation in Korean adults. Further studies are warranted to gain a better understanding of the association among vitamin D, depressive symptoms, and suicidal ideation.

Differences in Cortisol Response to Trauma Activation in Individuals with and without Comorbid PTSD and Depression

Background: Although depression symptoms are often experienced by individuals who develop posttraumatic stress disorder (PTSD) following trauma exposure, little is know about the biological correlates associated with PTSD and depression co-morbidity vs. those associated with PTSD symptoms alone.

Methods: Here we examined salivary cortisol responses to trauma activation in a sample of 60 survivors of the World Trade Center attacks on September 11, 2001. Participants recalled the escape from the attacks 7 months post 9/11. Salivary cortisol levels were measured before and after their recollection of the trauma. PTSD, depression, and somatic symptoms were also assessed. From the behavioral assessment scales, the participants were grouped into three conditions: those with comorbid PTSD and depressive symptoms, PTSD alone symptoms, or no-pathology.

Results: Baseline and cortisol response levels differed between the comorbid, PTSD alone, and no-pathology groups. Individuals endorsing co-morbid symptoms had higher PTSD and somatic symptom severity and their cortisol response decreased following their trauma reminder while a trend of an elevated response to the trauma was found in the PTSD alone group. Our findings show distinct psychological and biological correlates related to the endorsement of PTSD with and without depression comorbidity.

Conclusions: The findings suggest that comorbidity symptoms manifestation entails a separate trauma induced condition from PTSD. Future research on biological correlates of comorbid PTSD and depression is warranted.

Influence of intimate partner violence on mental status in Japanese women during the first trimester of pregnancy

OBJECTIVE

We examined the relation between intimate partner violence (IVP) and maternal mental status such as depression and anxiety.

METHODS

Between April 2016 and October 2016, we asked all Japanese women during the first trimester of pregnancy to answer the three self-administered questionnaires to screen IVP and depressive and anxiety symptoms.

RESULTS

There were 19 women who had a high score in the modified Violence Against Women Screen (VAWS) (4.1%, IPV group) and 408 women who had a score 0 (86.8%, control group). Overall, the rate of the women with depressive, anxiety, and depressive plus anxiety symptoms were 21.3, 31.5, and 16.0%, respectively. The rate of depressive and/or anxiety symptoms in the IPV group were significantly higher than those in the control group (Odds ratio = 5.02 and 7.40, p < .01 by X² test).

CONCLUSIONS

The significant adverse effect of IPV on maternal mental status seemed to be observed in Japanese women during the first trimester of pregnancy.

Factors related to prevalence, persistence, and incidence of depressive symptoms in mild cognitive impairment: vascular depression construct

OBJECTIVE

Depression is prevalent among elders with cognitive impairment. Cerebral white matter hyperintensities (WMH) have consistently been implicated in late-life depression and in cognitive impairment. This study aims to clarify the factors related to prevalence, persistence, and new onset of depressive symptoms in subjects with mild cognitive impairment (MCI).

METHODS

As part of a multicenter prospective study, the Clinical Research Center for Dementia of South Korea (CREDOS) Study, we enrolled 590 subjects diagnosed with MCI and with no prior history of depression. Depressive symptoms were assessed by the Korean version of the Geriatric Depression Scale short form (SGDS-K) at baseline and at follow-up visits. Brain magnetic resonance imaging was performed at baseline to quantify WMH using a visual rating scale.

RESULTS

The baseline prevalence of clinically significant depressive symptoms (SGDS-K ≥5) was 51.4%, and this feature was associated with younger age, lower educational achievement, and higher Clinical Dementia Rating Sum of Boxes (CDR-SB) scores. Persistence of depressive symptoms across the study period was significantly associated with baseline CDR-SB and depression scores. New onset of depression (SGDS-K ≥8; incidence 15.7%) among subjects free of depressive symptoms (SGDS-K <5) at baseline was associated with severe deep subcortical, but not periventricular, WMH.

CONCLUSIONS

In patients with MCI aged 50 years or older, depressive symptoms were highly prevalent. Cognitive status was closely related to both prevalence and persistence of depressive symptoms, while new onset of depression was associated with deep subcortical WMH severity in this MCI cohort. Our findings provide prospective evidence consistent with the vascular depression hypothesis. Copyright © 2015 John Wiley & Sons, Ltd.

Depressive symptoms in first-episode psychosis: a 10-year follow-up study

AIMS

The present study examined if any patient characteristics at baseline predicted depressive symptoms at 10 years and whether patients prone to depressive symptoms in the first year of treatment had a different prognosis in the following years.

METHOD

A total of 299 first-episode psychosis (FEP) patients with schizophrenia spectrum disorders were assessed for depressive symptoms with PANSS depression item (g6) at baseline, and 1, 2, 5 and 10 years of follow up. At 10 years, depressive symptoms were also assessed with Calgary Depression Scale for Schizophrenia (CDSS). A PANSS g6 ≥ 4 and CDSS score ≥ 6 were used as a cut-off score for depression.

RESULTS

A total of 122 (41%) patients were scored as depressed at baseline, 75 (28%) at 1 year, 50 (20%) at 2 years, 33 (16%) at 5 years, and 35 (19%) at 10 years of follow up. Poor childhood social functioning and alcohol use at baseline predicted depression at 10 years of follow up. Thirty-eight patients were depressed at both baseline and 1 year follow up. This group had poorer symptomatic and functional outcome in the follow-up period compared to a group of patients with no depression in the first year of treatment.

CONCLUSION

Depressive symptoms are frequent among FEP patients at baseline but decrease after treatment because their general symptoms have been initiated. Patients with poor social functioning in childhood and alcohol use at baseline are more prone to have depressive symptoms at 10 years of follow up. Patients struggling with depressive symptoms in the first year of treatment should be identified as having poorer long-term prognosis.

Gender-Related Factors for Depressive Symptoms in Turkish Adolescents

PROBLEM

Currently more adolescents suffer from mental health problems than compared to the past.

PURPOSE

This study was designed to extend the knowledge of depressive symptoms in adolescence and to determine the gender-related factors associated with it.

METHODS

The study sample consisted of (N = 487) adolescents. The Children's Depression Inventory (CDI), Multidimensional Scale of Perceived Social Support (MSPSS), Strengths and Difficulties Questionnaire (SDQ-S), and UCLA loneliness scale (UCLA-LS) were completed by the participants.

FINDINGS

Among the study population, 26.6% (n = 130) scored ≥ 19 on the CDI, which was the cut-off point. UCLA-LS, hyperactivity and conduct problems, and peer problems subscale scores of SDQ-S were found significantly higher in males (p < .05). Emotional symptoms, pro-social behavior subscale scores of SDQ-S, and a family member, a friend subscale scores of MSPSS were found significantly higher in females (p < .05). For males, loneliness and hyperactivity and conduct problems, while for females, emotional symptoms and loneliness (p < .05) were predictive variables. Pro-social behavior and perceived family member support were protective variables for females scoring high enough to be diagnosed with depression (p < .05).

CONCLUSION

We suggest further studies to confirm these results as well as establishing strategies for better detection of depressive symptoms when working on adolescents.

Applications of Text Messaging, and Bibliotherapy for Treatment of Patients Affected by Depressive Symptoms

BACKGROUND

Intensity of depressive symptoms could be exacerbated due to the paucity of appropriate treatments. We assessed the effectiveness of bibliotherapy and text messaging, which aimed at amelioration of patient's behavior and consciousness, which could lead to suicide prevention.

METHODS

This was a randomized clinical trial implemented in rural health centers of Isfahan district (Iran). Health centers were assigned in three trials consisting of the booklet, text messaging, and control groups. Each group consisted of 70 patients. Inclusion criteria were being affected by depressive symptom, <18 years, and cell phone accessibility. Mental retardation, drug and alcohol abuse, visual disability, dementia, suicide attempt history, electrotherapy, and receiving psychological interventions were our not met criteria. Our patient outcomes comprised intensity of depressive symptom and treatment compliance. The first two trials were requested to study instructive booklets in 30 days while the second cohort was demanded to study the booklet in accordance with the daily delivered text messaging.

RESULTS

Out of 210 individuals, 198 patients finished this study. The intensity of depressive symptom was significantly affected through time and group factors as well as time-group interaction (F = 12.30, P < 0.001). Based on treatment compliance, the interactive effect of group factor and the time factor was statistically significant.

CONCLUSIONS

It seems that bibliotherapy could efficiently decrease the intensity of depressive symptoms. Nevertheless, in comparison with our booklet trial, the text messaging group achieved neither durable nor significant success; thus, bibliotherapy could be utilized as a complementary methodology aiming depression treatment.

Assessment of psychiatric morbidity and quality of life in children and adolescents with cutaneous leishmaniasis and their parents

Introduction

Cutaneous leishmaniasis (CL) is a common parasitic infectious disease caused by different species of the leishmania genus. The skin lesions are usually found on exposed areas, especially the face, arms and legs. Although the disease does not cause significant morbidity, the lesions can be troublesome and unsightly. The disease have negative impacts in areas such as patients’ psychological well-being, social life and daily activities in adults.

Aim

To determine the frequency of psychiatric morbidity in children and adolescents who have cutaneous leishmaniasis (CL) and to determine the effect of CL on their levels of depression and anxiety and on their quality of life (QoL).

Material and methods

Fifty-four patients with CL (29 males and 25 females), who were 7 to 18 years of age, were assessed with the Child Depression Inventory (CDI) and the State-Trait Anxiety Inventories for Children (STAIC). The patients and their mothers were assessed with the Pediatric Quality of Life Inventory Parent and Child Versions (PedQL-P and C, respectively). This questionnaires were filled in by the control group consisting of 40 healthy children and adolescents (20 males and 20 females) and their parents from the local community matched for age, gender, and education level of the parents.

Results

Both the patient group and the control group had high scores on the depression measurement scale (t = 5.36, p < 0.05). These measurements also show significant differences between children and adolescents, who were defined as 12 years of age and under as well as older than 12 years, respectively (12 years of age and under (t = 3.14, p = 0.04); over 12 years (t = 5.37, p < 0.001)). However, there was no significant difference between the anxiety scores of the general patient group and the control group when classified according to age. The anxiety sensitivity index scores did not differ in either group from those of the control group. The patients’ and the mothers’ QoL scores for all of the scales, including all subscale scores, were significantly different from those of the control group (both 12 years of age and under as well as older than 12 years).

Conclusions

The results have shown that the frequency of depressive symptoms is much higher in patients who have CL than in healthy controls. In addition, the QoL of children and adolescents with CL and of their mothers was found to be much lower than that of the control group. Therefore, the follow-up for patients with CL who are referred to dermatology clinics should include a psychiatric evaluation. If necessary, they should be referred for psychiatric support.

SLEEP DURATION AND DEPRESSION AMONG ADULTS: A META-ANALYSIS OF PROSPECTIVE STUDIES

BACKGROUND

Results from longitudinal studies on sleep duration and incidence of depression remain controversial.

METHODS

PubMed and Web of Science updated on October 22, 2014 were searched for eligible publications. Pooled relative risks (RRs) with 95% confidence interval (CI) were calculated using a random-effects model.

RESULTS

Seven prospective studies were included, involving 25,271 participants for short sleep duration and 23,663 participants for long sleep duration. Compared with the normal sleep duration, the pooled RR for depression was 1.31 (95% CI, 1.04-1.64; I(2) = 0%) for the short sleep duration overall. For long sleep duration, the pooled RR was 1.42 (95% CI, 1.04-1.92; I(2) = 0%). The associations between short or long sleep duration and risk of depression did not substantially change in sensitivity and subgroup analyses. No evidence of publication bias was found.

CONCLUSION

This meta-analysis indicates that short and long sleep duration was significantly associated with increased risk of depression in adults.

Anxiety and depressive symptoms among patients infected with human immunodeficiency virus in South Korea

Patients infected with human immunodeficiency virus (HIV) may develop mental health problems such as anxiety and depression, which negatively impact of disease progression. We investigated factors associated with the prevalence of anxiety and depression symptoms among HIV-infected patients in Korea. A total of 840 HIV-infected patients who participated in the Korea HIV/AIDS Cohort Study from 2006 to 2012 were evaluated. Socio-demographic, epidemiologic, and clinical variables were obtained through standardized questionnaires. The State-Trait Anxiety Inventory and Beck Depression Inventory were used to assess the symptoms of anxiety and depression. Multiple logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of anxiety and depressive symptoms among HIV-infected patients was 32% and 36%, respectively. Ex-smoker and persistent symptoms for more than one week within the past six months and diagnosis of HIV infection within one year were associated with increased anxiety symptoms (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.09-2.69; OR 1.52, 95% CI 1.09-2.11; OR 1.49, 95% CI 1.02-2.20) and current smoking and persistent symptoms were also associated with increased depressive symptoms (OR 2.10, 95% CI 1.31-3.30; OR 1.87, 95% CI 1.25-2.79). Marital status, current smoking, current drinking, and persistent symptoms were associated with both increased anxiety and depressive symptoms (OR 1.75, 95% CI 1.07-2.88; OR 1.66, 95% CI 1.06-2.61; OR 1.88, 95% CI 1.18-2.99). The prevalence of anxiety and depressive symptoms among HIV-infected patients is higher than those estimated for the general population. This study shows the necessity to evaluate symptoms of anxiety and depression and suggest psychological support for HIV-infected patients who smoke or have persistent symptoms or have sexual partner or drink.

Tea consumption and the risk of depression: a meta-analysis of observational studies

OBJECTIVE

Whether tea consumption decreases the risk of depression remains controversial. We performed a meta-analysis of findings from observational studies to evaluate the association between tea consumption and depression risk.

METHOD

Embase, PubMed, and Chinese National Knowledge Infrastructure databases were searched from their inception through August 2014 for observational studies that had reported the association between tea consumption and depression risk. We used a fixed effects model when heterogeneity was negligible and a random effect model when heterogeneity was significant to calculate the summary relative risk estimates (RRs) and 95% confidence intervals (CIs).

RESULTS

Eleven studies with 13 reports were eligible for inclusion in the meta-analysis (22,817 participants with 4,743 cases of depression). Compared to individuals with lower tea consumption, those with higher tea consumption had a pooled RR of depression risk at 0.69 (95% CI: 0.63-0.75). Eight reports were included in the dose-response analysis of tea consumption and depression risk (10,600 participants with 2,107 cases). There was a linear association between tea consumption and the risk of depression, with an increment of 3 cups/day in tea consumption associated with a decrease in the risk of depression of 37% (RR = 0.63, 95% CI: 0.55-0.71).

CONCLUSION

Tea consumption is associated with a decreased risk of depression.

Open prospective study of ziprasidone in patients with schizophrenia with depressive symptoms: a multicenter study

AIMS

The goal of this study was to examine the efficacy and safety of ziprasidone to treat depressive symptoms in Korean patients with schizophrenia who showed stable symptoms.

METHODS

In this 8-week, open-label, prospective, non-randomized, multicenter study, 34 patients with schizophrenia who showed a stable response to previous medications, maintained a stable dose, and who had depressive symptoms, were recruited. Ziprasidone was the only antipsychotic agent allowed for 8 weeks after a 2-7-week washout period.

RESULTS

Steady decreases were observed on the Montgomery-Asberg Depression Rating Scale, the Calgary Depression Scale for Schizophrenia, the Positive and Negative Syndrome Scale, and the Clinical Global Impression-Severity Scale scores. The Montgomery-Asberg Depression Rating Scale score was 20.26 ± 4.77 at baseline and 12.21 ± 7.94 at the end-point (P < 0.01). The Calgary Depression Scale for Schizophrenia score was 9.76 ± 4.11 at baseline and 5.00 ± 3.94 at the end-point (P < 0.01). The Positive and Negative Syndrome Scale total score was 75.24 ± 22.63 at baseline and 66.53 ± 24.28 at the end-point (P < 0.01). The Clinical Global Impression-Severity Scale score was 3.44 ± 0.66 at baseline and 3.15 ± 0.86 at the end-point (P < 0.05). No significant differences were observed for total scores on the Simpson and Angus Rating Scale, the Barnes Akathisia Rating Scale, or the Abnormal Involuntary Movement Scale between the baseline and end-point.

CONCLUSIONS

Ziprasidone was effective for improving depressive symptom scores and was well tolerated. Switching to ziprasidone is a good strategy in patients with schizophrenia who are experiencing depressive symptoms.

Effects of stress and depression on inflammatory immune parameters in pregnancy

There is a substantial body of literature that links psychological stress to adverse pregnancy outcomes, particularly preterm birth. Comparatively few studies have examined potential biologic mechanisms that explain these associations. Attention to inflammatory processes is warranted. This article describes emerging studies that demonstrate that, as in nonpregnant humans and animals, psychological stress and distress (ie, depressive symptoms) predict dysregulation of inflammatory processes in human pregnancy. This includes elevations in circulating inflammatory cytokines, exaggerated inflammatory responses to in vivo biologic challenges, and more robust inflammatory responses to psychological challenges. Continued research in this area is needed to determine the implications of such stress-induced immune dysregulation for birth outcomes and for maternal health and fetal development.

Association between total sleep duration and suicidal ideation among the Korean general adult population

STUDY OBJECTIVES

Examine the association between sleep duration and suicidal ideation in Korean adults.

DESIGN

Cross-sectional survey.

SETTING

Data obtained by the Korea National Health and Nutrition Examination Survey IV (2007-2009) using a rolling sampling design involving a complex, stratified, multistage, and probability-cluster survey of civilian non-institutionalized Korean residents.

PARTICIPANTS

A total of 15,236 subjects (6,638 males and 8,598 females) ≥ 19 years old.

MEASUREMENTS AND RESULTS

The weighted prevalence of self-reported short sleep duration (≤ 5 h/day) was 11.7% in males and 15% in females, and of long sleep duration (≥ 9 h/day) was 6.7% in males and 8.9% in females. A U-shaped relationship existed, with both short and long sleep durations associated with a higher suicidal ideation risk. Multiple logistic regression analysis was used to analyze the relationship between sleep duration and suicidal ideation, adjusting for sociodemographic factors, health behavior, and health status. After controlling for covariates, people with short sleep were 38.1% more likely to have suicidal ideation (OR = 1.381, 95% CI 1.156-1.650) than people with sleep duration of 7 h/day. Suicidal ideation was 1.196 times higher (95% CI: 0.950-1.507) in long-sleeping people than people sleeping 7 h/day, although statistically not significant. Inclusion of depressive mood (a potential confounder) in multiple logistic regression models attenuated but did not eliminate the sleep duration/suicidal ideation association.

LIMITATIONS

Sleep duration and suicidal ideation were assessed only by self-report.

CONCLUSIONS

The sleep duration/suicidal ideation relationship is U-shaped in the Korean adult population. Self-reported habitual sleep duration may be a useful behavioral indicator for both individual and societal suicidal ideation risk.

Cognitive emotion regulation strategies as predictors of depressive symptoms in women newly diagnosed with breast cancer

OBJECTIVE

This study aimed to determine the effects of cognitive emotion regulation strategies on depressive symptoms in women with breast cancer.

METHODS

Five hundred and nine women with breast cancer completed a demographic survey, the Chinese version of Cognitive Emotion Regulation Questionnaire (CERQ-C), and the Center for Epidemiological Studies Depression Scale (CES-D) at the initial assessment (T1). One month later (T2), 504 patients completed the CES-D. Patients were assigned to four groups: H-H (CES-D scores ≥16 at both timepoints), H-L (CES-D score ≥16 at T1, <16 at T2), L-H (CES-D score <16 at T1, ≥16 at T2) and L-L (CES-D scores <16 at both timepoints).

RESULTS

Over 80% patients had mild or no depressive symptoms at both timepoints. There were significant group differences in cognitive emotion regulation strategies. CERQ-C subscale scores for adaptive strategies were higher, and scores for maladaptive strategies were lower among patients in L-L and H-L groups than among those in H-H group. Hierarchical regression analyses showed that cognitive emotion regulation strategies at T1 differentiated depressive symptoms at T2, accounting for 56.5% of variance after controlling for sociodemographic and biological variables and baseline levels of depression. Greater acceptance, positive refocusing, and positive reappraisal at T1 were associated with fewer depressive symptoms at T2.

CONCLUSIONS

Cognitive emotion regulation strategies accounted for considerable variance in depressive symptom scores 1 month later. The strategies of acceptance, positive refocusing, and positive reappraisal may be beneficial for women with breast cancer. Intervention studies are needed to confirm if these associations are causal.

Interaction between a serotonin transporter gene promoter region polymorphism and stress predicts depressive symptoms in Chinese adolescents: a multi-wave longitudinal study

BACKGROUND

The serotonin transporter (5-HTT) gene may play an important role in the onset and development of mental disorders. Past studies have tested whether a functional polymorphism in the 5-HTT gene linked promoter region (5-HTTLPR) moderated the association between stress and depressive symptoms, but the results of these studies were inconsistent. Thus, the aim of the current study was to examine the interaction between 5-HTTLPR and stress that predict depressive symptoms in Chinese adolescents.

METHODS

A total of 252 healthy adolescents (131 females and 121 males, aged from 14 to 18, mean = 16.00, standard deviation = 0.60) participated in this study. During the initial assessment, all participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and Adolescent Life Events Questionnaire (ALEQ) and were genotyped for the 5-HTTLPR polymorphism. Participants subsequently completed CES-D and ALEQ once every three months during the subsequent 24 months. A multilevel model was used to investigate the 5-HTTLPR × stress interaction in predicting depressive symptoms.

RESULTS

The results indicated no main effect of 5-HTTLPR and a significant 5-HTTLPR × stress interaction in females only. Females with at least one 5-HTTLPR S allele exhibited more depressive symptoms under stressful situations. No significant 5-HTTLPR × stress interaction was found in males.

CONCLUSIONS

In Chinese adolescents, there are gender differences on the interaction between 5-HTTLPR and stress that predict depressive symptoms. The association between stress and depressive symptoms is moderated by 5-HTTLPR in Chinese female adolescents.

The moderating effect of nutritional status on depressive symptoms in veteran elders with dementia: a spaced retrieval combined with Montessori-based activities

AIM

To examine the long-term effects of fixed/individualized spaced retrieval combined with Montessori-based activities on nutritional status and body mass index and nutritional improvement's moderating effect on depressive symptoms for people with dementia during a specific follow-up period.

BACKGROUND

The decrease in food intake, often combined with poor nutrition, may induce depressive symptoms in people with dementia.

DESIGN

A single-blind, quasi-experimental study with repeated measures.

METHODS

Twenty-five fixed group participants received spaced retrieval combined with Montessori-based activities over 24 sessions. Thirty-eight individualized group participants received the same intervention with different sessions, which was adjusted according to each participant's learning response. Twenty-seven control group participants just received routine care. The Chinese version of the Mini-Nutritional Assessment and Cornell Scale for Depression in Dementia scores and body mass index were recorded at pre-test, posttest and 1-, 3- and 6-month follow-ups. Data were collected between July 2008-February 2010.

RESULTS

The Mini-Nutritional Assessment scores and body mass index of the fixed and individualized groups could be significantly increased over time. Additionally, the Cornell Scale for Depression in Dementia scores could be significantly reduced as a result of the improvement of the Mini-Nutritional Assessment scores arising from the individualized intervention.

CONCLUSION

The depressive symptoms of residents with dementia could be moderated by the individualized intervention through nutritional improvement. Trained clinical nurse specialists can use this individualized intervention for residents with dementia who also have poor nutrition and depressive symptoms.